CH 24-26
Which of the following statements regarding low-energy penetrating injuries is correct?
The area of injury is usually close to the path the object took through the body.
If a patient has a penetrating injury to the neck that results in an open wound what should the EMT do?
Use occlusive dressings.
Significant vital sign changes will occur if the typical adult acutely loses more than ______ of his or her total blood volume.
20%
Which of the following could be considered a secondary blast injury?
Injuries sustained when flying debris strikes the victim.
Which of the following statements regarding the first collision that occurs during a motor vehicle crash is correct?
It is the most dramatic part of the collision and may make extrication difficult.
Why should on-scene time be limited to 10 minutes or less for trauma patients?
Surgical intervention is usually required
Evaluation of the interior of a crashed motor vehicle during extrication will allow the EMT to:
identify contact points and predict potential injuries.
How many categories of trauma are there?
2
Which of the following areas of the body has the thinnest skin?
Ears
Kinetic energy is a calculation of:
Mass and velocity
A fractured femur can result in the loss of ______ or more of blood into the soft tissues of the thigh.
1 L
A 21-year-old male was working in an auto repair shop and sustained radiator burns to the anterior aspect of both arms and to his anterior chest. According to the rule of nines this patient has burns that cover _____ of his BSA.
18%
A 5-year-old female pulled a pot of boiling water from the stove. She has superficial and partial-thickness burns to her head face, and anterior trunk. What percentage of her body surface area has been burned?
30%
What is the approximate blood volume of a 75-kg adult?
5.25 L
The body has increasing difficulty in compensating for shock and traumatic injuries after how long?
60 minutes
During your assessment of a patient with a head injury you note that he opens his eyes when you pinch his trapezius muscle, is mumbling, and has his arms curled in toward his chest. You should assign him a GCS score of:
7
Which of the following would cause blunt trauma?
A motor vehicle collision
Which of the following statements regarding the clotting of blood is correct?
A person taking aspirin will experience slower blood clotting.
In which of the following patients should you remove an impaled object?
A pulseless and apneic patient with a knife impaled in the back
Which of the following open soft-tissue injuries is limited to the superficial layer of the skin and results in the least amount of blood loss?
Abrasion
Which of these reasons would be an appropriate use of emergency air medical services for trauma patients? Traffic conditions or hospital availability make it unlikely that the patient will get to trauma center via ground within ideal time frame. There is a mass casualty incident Distance to the trauma center is greater than 20 to 25 miles
All of these answers are correct
Which of the following would be considered a significant mechanism of injury? A car-versus-pedestrain accident greater than 15 mph Death of an occupant in the vehicle Motor vehicle collision greater than 40 mph or motorcycles crashes greater than 20 mph
All of these answers are correct.
Which of the following would be considered multi system trauma? Chest and multiple extremity trauma Head and spinal trauma Chest and abdominal trauma
All of these answers are correct.
Which of the following would MOST likely result from the third collision in the three-collision effect that occurs during a high-speed frontal impact, motor vehicle collision?
Aortic rupture or compression injury to the brain
When caring for victims of traumatic injuries what should an EMT do to avoid delays in treatment and transport?
Call for ALS and helicopter assistance early.
Which of the following occurs when a medium- or high-velocity object enters the body and creates rapid changes in tissue and fluid pressure that occur with the passage of the projectile?
Cavitation
A small compact car was involved in a rollover crash. As you are approaching the vehicle you note that the roof is significantly collapsed. The patient, a 29-year-old male, is complaining of severe pain in his neck and to the top of his head as well as numbness and tingling in his extremities. Witnesses who removed the patient from the vehicle state that he was wearing his seatbelt. What injury mechanism is MOST likely responsible for this patient's condition?
Compression of the head against the roof
Which of the following statements regarding crush syndrome is correct?
Compromised arterial blood flow leads to crush syndrome and can occur when an area of the body is trapped for longer than 4 hours.
A 33-year-old male sustained an abdominal evisceration to the left lower quadrant of his abdomen after he was cut with a large knife. After appropriately managing his ABCs and assessing him for other life-threatening injuries how you should care for his wound?
Cover it with moist, sterile gauze and secure with an occlusive dressing.
In the case of a motor vehicle crash the energy of the speeding vehicle is converted into the work of stopping the vehicle, which is accomplished by:
Crushing the vehicle's exterior.
Which of the following mnemonics works BEST when assessing a trauma patient?
DCAP-BTLS
Which of the following is important to do when treating a patient with penetrating trauma?
Determine the length of the penetrating object.
When a driver is in a car equipped with an air bag but is not wearing a seatbelt, he or she will MOST likely strike the __________ when the air bag deploys upon impact.
Door
All of the following are concepts of energy EXCEPT:
Expressed energy
Which of the following statements regarding penetrating injuries is correct?
External bleeding may be minimal but internal injuries can be extensive.
All of the following are criteria that can help identify a critically injured patient EXCEPT:
Injuries to the head
Which of the following is an example of a nonsignificant injury?
Injury to an isolated body part.
According to the Journal of safety research which type of crash causes approximately 30% of all fatalities that occur in motor vehicle crashes?
Lateral
Which level of trauma center would fit the definition that includes "able to provide prompt assessment resuscitation, and stabilization of injured patients and emergency operations"?
Level III
Which of the following is a sign of compartment syndrome?
Pain upon passive movement of the injury site
Which of the following is a severe burn in a 65-year-old patient?
Partial-thickness burn to 20% of the BSA
Which of the following statements regarding hemophilia is correct?
Patients with hemophilia may bleed spontaneously.
Which of the following is NOT true regarding digital photos of a crash scene?
Photos can be shared over social media.
A patient is suffering from decreasing blood pressure asymmetrical chest wall movement, and a narrow pulse pressure. You should have a high index of suspicion for which of the following conditions?
Pneumothorax or hemothorax
Which category of blast injuries includes mental health emergencies?
Quaternary
Which of the following statements regarding severe burns is correct?
Severe burns are typically a combination of various degrees of burns.
For the symptoms of noisy or labored breathing decreasing or low GCS score, and a rapid, weak pulse, which of the following injuries would you expect?
Significant bleeding or foreign bodies in the upper or lower airway.
Which of the following might be the only sign of blunt trauma?
Skin discoloration
If a person is standing near a building that explodes which of the following injuries would he or she MOST likely experience as a result of the pressure wave?,
Stomach rupture
Which of the following injuries would NOT be a primary blast injury?
Suffocation
Which of the following processes occurs during the inflammation phase of the healing process?
The immune system releases histamines, which cause vasodilation and increased capillary permeability, resulting in local redness and swelling.
When assessing a patient who fell you need to estimate all of the following, EXCEPT:
The speed at which the person hit the ground.
Which of the following injuries can be used to assist in triaging patients because they indicate risk of pressure injuries to the lungs?
Tympanic membrane injuries.
It is important to consider_____ as well as obvious injuries with any type of trauma.
Unseen
Which of the following patients has experienced the MOST significant fall?
a 4′6″ patient who fell 13 feet
In order for electricity to flow through the body and cause damage:
a complete circuit must exist between the electrical source and the ground.
If direct pressure with a sterile dressing fails to immediately stop severe bleeding from an extremity you should apply:
a tourniquet proximal to the injury.
Blood stasis changes in the vessel wall, and certain medications affect the:
ability of the blood to effectively clot.
A 39-year-old male was struck in the head by a baseball during a game. He is confused and has slurred speech. He has a large hematoma in the center of his forehead and cannot remember the events preceding the injury. After manually stabilizing his head and assessing his airway, you should:
administer high-flow oxygen.
During your assessment of a 22-year-old male who was assaulted you note widespread contusions and abrasions to his face, chest, and abdomen. His pulse is rapid and weak, and his skin is cool and clammy. You should:
administer oxygen and prepare for rapid transport.
Which of the following splinting devices would be MOST appropriate to use for a patient who has an open fracture of the forearm with external bleeding?
air splint
In addition to severe bleeding the MOST life-threatening complication associated with an open neck injury is:
an air embolism.
Most cases of external bleeding from an extremity can be controlled by:
applying local direct pressure.
When evaluating the mechanism of injury of a car-versus-pedestrian collision you should first:
approximate the speed of the vehicle that struck the pedestrian.
The smaller vessels that carry blood away from the heart and connect the arteries to the capillaries are called the:
arterioles.
You have applied a dressing and roller-gauze bandage to a laceration on the arm of a young female. During transport she begins to complain of numbness and tingling in her hand. You should:
assess distal circulation and readjust the bandage as needed.
A young male was shot in the abdomen by an unknown type of gun. He is semiconscious has shallow breathing, and is bleeding externally from the wound. As you control the external bleeding, your partner should:
assist the patient's ventilations.
When treating a patient who experienced a pulmonary blast injury you should:
avoid giving oxygen under positive pressure.
When treating a partial-thickness burn you should:
avoid the use of creams, lotions, or antiseptics.
While assessing a young male who was struck in the chest with a steel pipe you note that his pulse is rapid and irregular. You should be MOST suspicious for:
bruising of the heart muscle.
When caring for a patient whose arm is covered with a dry chemical you should:
brush away the chemical before flushing with water.
In contrast to animal bites the bite of a human:
carries with it a wide variety of virulent bacteria and viruses.
Perfusion is MOST accurately defined as the:
circulation of blood within an organ in adequate amounts to meet the body's metabolic needs.
The germinal layer of the epidermis contains pigment granules that are responsible for skin:
color.
A 30-year-old male experienced a crushing injury when his forearm was trapped between the back of a truck and a loading dock. Upon your arrival the man's arm has been freed. Your assessment reveals that his arm is obviously deformed and swollen and is cold and pale. Further assessment reveals an absent radial pulse. You should be MOST concerned that this patient has:
compartment syndrome.
A 39-year-old male accidentally cut his wrist while sharpening his hunting knife. He is conscious and alert with adequate breathing but is bleeding significantly from the wound. You should:
control the bleeding with direct pressure.
A construction worker fell approximately 30 feet and landed in a pile of steel rods. Your assessment reveals that he is pulseless and apneic and has a 10-inch steel rod impaled in his left leg. You should:
control the bleeding, begin CPR, stabilize the steel rod, immobilize his spine, and transport immediately.
A closed soft-tissue injury characterized by swelling and ecchymosis is called a(n):
contusion.
Burns are classified according to:
depth and extent.
In nontrauma patients an early indicator of internal bleeding is:
dizziness upon standing.
Two of the MOST common mechanisms of injury for blunt trauma are:
falls and motor vehicle collisions.
In which of the following situations would external bleeding be the MOST difficult to control?
femoral artery laceration and a blood pressure of 140/90 mm Hg
As red blood cells begin to clump together to form a clot, __________ reinforces the clumped red blood cells.
fibrinogen
A 39-year-old male sustained a large laceration to his leg during an accident with a chainsaw and is experiencing signs and symptoms of shock. You should:
follow appropriate standard precautions.
A 67-year-old male presents with weakness dizziness, and melena that began approximately 2 days ago. He denies a history of trauma. His blood pressure is 90/50 mm Hg and his pulse is 120 beats/min and thready. You should be MOST suspicious that this patient is experiencing:
gastrointestinal bleeding.
In contrast to a Level III trauma center a Level I trauma center must:
have general surgeons who are in-house 24 hours a day.
Gastrointestinal bleeding should be suspected if a patient presents with:
hematemesis.
The ability of a person's cardiovascular system to compensate for blood loss is MOST related to:
how rapidly he or she bleeds.
Functions of dressings and bandages include all of the following EXCEPT:
immobilization of the injury.
In addition to external bleeding the MOST significant risk that an open soft-tissue injury exposes a patient to is:
infection.
Bleeding from the nose following head trauma:
is a sign of a skull fracture and should not be stopped.
You arrive at the home of a 50-year-old female with severe epistaxis. As you are treating her
it is MOST important to recall that:,
The energy of a moving object is called:
kinetic energy.
A hematoma develops when:
large blood vessels beneath the skin are damaged.
When assessing the interior of a crashed motor vehicle for damage you are gathering information regarding the:
mechanism of injury.
An abdominal evisceration:
occurs when organs protrude through an open wound.
As you approach a young male who was involved in an industrial accident you note that his eyes are closed and that he is not moving. You can see several large contusions to his arms, a laceration to his forehead with minimal bleeding, and a closed deformity to his right leg. You should:
open his airway and assess his breathing status.
Early signs and symptoms of intra-abdominal bleeding include:
pain and distention.
Burns to pediatric patients are generally considered more serious than burns to adults because:
pediatric patients have more surface area relative to total body mass.
A 43-year-old man is experiencing a severe nosebleed. His blood pressure is 190/110 mm Hg and his heart rate is 90 beats/min and bounding. Appropriate treatment for this patient includes:
pinching the patient's nostrils and having him lean forward.
A 30-year-old male sustained a stab wound to the neck when he was attacked outside a nightclub. During your assessment you should be MOST alert for:,
potential airway compromise.
A 22-year-old male was kicked in the abdomen multiple times during an attack by a gang. He is conscious but restless and his pulse is rapid. Your assessment reveals a large area of bruising to the right upper quadrant of his abdomen. The MOST appropriate treatment for this patient includes:
preparing for immediate transport.
During transport of a 40-year-old female with acute abdominal pain you note that she has stopped talking to you and has become extremely diaphoretic. You should:
repeat the primary assessment.
A 56-year-old male has an incomplete avulsion to his right forearm. After controlling any bleeding from the wound you should:
replace the avulsed flap to its original position and cover it with a sterile dressing.
An 8-year-old male was bitten by a stray dog. He has a large laceration to the back of his left hand which your partner covered with a sterile dressing and bandage. In addition to transporting the child to the hospital, you should:
report the incident to the appropriate authorities.
The systemic veins function by:
returning deoxygenated blood back to the heart.
Hypoperfusion is another name for:
shock
During your assessment of a patient who was shot in the abdomen you notice a large entrance wound with multiple small puncture wounds surrounding it. This wound pattern is MOST consistent with a:
shotgun
Which of the following organs can tolerate inadequate perfusion for up to 2 hours?
skeletal muscle
Following blunt trauma to the abdomen a 21-year-old female complains of left upper quadrant abdominal pain with referred pain to the left shoulder. Your assessment reveals that her abdomen is distended and tender to palpation. On the basis of these findings, you should be MOST suspicious of injury to the:
spleen
When using a stick and square knot as a tourniquet to control severe bleeding from an amputated arm the EMT should:
stop twisting the stick when the bleeding stops.
A burn that is characterized by redness and pain is classified as a:
superficial burn.
The severity of bleeding should be based on all of the following findings EXCEPT:
systolic blood pressure.
hypovolemic shock occurs when
the body cannot compensate for rapid blood loss.
Internal injuries caused by gunshot wounds are difficult to predict because:
the bullet may tumble or ricochet within the body.
You are assessing a 30-year-old woman with multiple large bruises to her chest and abdomen that she experienced during an assault. She is conscious but restless and her skin is cool and pale. You should be MOST concerned with:
the fact that her clinical signs could indicate that she is bleeding internally.
Which of the following body systems or components is the LEAST critical for supplying and maintaining adequate blood flow to the body?
the filtering of blood cells in the spleen
You and your partner arrive at the scene of a house fire where firefighters have rescued a 50-year-old male from his burning house. The patient has superficial and partial-thickness burns to his face and chest. His nasal hairs are singed and he is coughing up sooty sputum. You should be MOST concerned with:
the potential for airway swelling.
Functions of the skin include all of the following EXCEPT:
the production of key antibodies.
Factors that should be considered when assessing a patient who has fallen include all of the following EXCEPT:
the speed of the fall.
Whether you are using a commercial device or a stick and triangular bandage as a tourniquet it is important to remember that:
the tourniquet should only be removed at the hospital because bleeding may return if the tourniquet is released.
Passengers who are seated in the rear of a vehicle and are wearing only lap belts have a higher incidence of injuries to the _____________ spine during a rear-end crash.
thoracic and lumbar
The driver of a sport utility vehicle lost control and struck a utility pole head-on. The driver was killed instantly. The passenger a young female, is conscious and alert and has several small abrasions and lacerations to her left forearm. Treatment for the passenger should include:
transport to a trauma center.
External bleeding from a vein is relatively easy to control because:
veins are under a lower pressure.
The sebaceous glands produce sebum a material that:
waterproofs the skin and keeps it supple.
In older patients the first indicator of nontraumatic internal bleeding may be:
weakness or dizziness.
After applying a pressure dressing to a laceration on a patient's arm you notice that blood is slowly beginning to saturate it. You should:
you notice that blood is slowly beginning to saturate it. You should:place additional dressings over the wound.
